1. Field of the Invention
The present invention pertains to apparatus for enhancing surgical skills. More specifically, the present invention pertains to apparatus for supporting a specimen of a body organ for practicing surgery thereon. In particular, the present invention provides apparatus for enhancing the skills of a surgeon in performing laser surgery of the female reproductive organs by supporting a post-hysterectomy specimen for surgical practice thereon.
2. Description of the Prior Art
Menorrhagia, the medical term for abnormal bleeding of the uterus, may occu anytime between menarche and menopause. When the cause of bleeding is structural, such as polyps or fibroid tumors, a hospital dilatation and curettment (D & C) under general anesthesia is usually recommended. Most often D & C provides only a temporary solution to the problem. Studies indicate that relief from menorrhagia is achieved in only zero to fifty percent of the patients. When menorrhagia is the result of hormonal imbalance, oral contraceptives or other drugs may be prescribed. If these excepted treatments do not provide positive results, it may be necessary to perform a hysterectomy. Each year approximately 750,000 hysterectomies are performed in the United States alone, one-third of which are performed for excessive uterine bleeding. A hysterectomy is a major surgical procedure with significant risks. An average of four to seven days of hospitalization is required for recovery. Thus, significant expense is incurred by hospitalization and loss of productivity.
In recent years, laser surgery or ablation has been developed for treatment of menorrhagia as an alternative for hysterectomy. The term "laser" stands for light amplification by stimulated emission of radiation. Light waves are intensified and focused into a narrow, concentrated beam of light that is converted to heat at the target tissue. A type of laser, the CO.sub.2 laser, has been used in gynecologic surgery for more than a decade in the treatment of such common conditions as venereal warts and pre-cancerous lesions of the cervix. The CO.sub.2 laser cuts deeply with an intense infrared light produced by the electrical stimulation of a mixture of carbon dioxide, nitrogen and helium gases. The CO.sub.2 laser literally vaporizes tissue when its heat is absorbed by the moisture in the cells, and converts the moisture to steam. In more recent developments, the YAG laser has been developed for commercial use in hospitals. The YAG laser uses a solid yttrium aluminum garnet crystal and the rare element neodyminum to produce an intense infrared light.
In the accepted protocol for YAG laser ablation, a D & C or endometrial biopsy is first obtained in the hospital or the office to rule out any endometrial patholoty such as cancer. For approximately three weeks or longer the male hormone Danazol (trade name: Danocrine) is prescribed to temporarily inhibit the ovaries from hormone production. This produces a thin atrophic endometrium which will be only a few millimeters thick.
After proper preparation, laser surgery is then performed in a hospital or freestanding clinic where a YAG laser and equipment are available. Under general or epidural anesthesia, a hysterescope (a telescope-like instrument) is passed through the cervical canal and into the uterine cavity. By direct visualization, the thin atrophic endometrium can be seen. A fiberoptic cord is passed through the hysterescope. The YAG laser beam is then emitted via the tip of the fiber optic cord. Under direct visualization the endometrium is ablated and destroyed. The surrounding myometrium (uterine muscle) will shrink and become smaller.
Where appropriate, laser ablation offers a number of advantages:
(1) The procedure is usually performed on an outpatient basis and required only thirty to forty-five minutes for an experienced surgeon. PA0 (2) There is little or no pain or discomfort. PA0 (3) The patient is able to return to work within one to two days of surgery. PA0 (4) All of the female organs remain intact (cervix, uterus and ovaries). PA0 (5) The cost is significantly less when compared to that of a hysterectomy. PA0 (6) Loss of income and time from employment is substantially reduced. PA0 (7) Insurance companies may pay most or all of the medical expenses if the procedure is performed on an outpatient basis.
FDA approval of YAG laser ablation as an alternative to hysterectomy and D & C for treatment of menorrhagia was granted in 1986. Such approval will allow trained gynecologists to use the YAG laser as an alternative treatment of pelvic endometrosis and bicornuate uterus. It may also be an effective surgical treatment with minumal discomfort and trauma for the mentally retarded who have difficulty in caring for menstrual needs. Laser ablation of the endometrium is also a sterilizing procedure and many females may select this procedure as a method of accomplishing sterilization and decreasing menstrual flow. Laser ablation may also be useful for treatment of postmenopausal women being treated with hormone treatment replacement therapy who continue to have vaginal bleeding.
YAG laser surgery is very precise and one of the problems, of course, for surgeons learning this new procedure and enhancing their skills is obtaining the necessary practice. Of course, an inexperienced surgeon should not be allowed to practice this procedure on a patient. Thus, the procedure is normally practiced on a post-hysterectomy specimen. Supporting and positioning the post-hysterectomy specimen for practice of YAG laser surgery thereon has presented somewhat of a problem.